AIDS Denialist Crank Convention: Gearing Up for Oakland

"They are all prostitutes, most of them, my collogues, to some degree, including myself. You have to be prostitutes to get money for your research. You are trained a little bit to be a prostitute. But some go all the way." Peter Duesberg

I don’t know about you, but I am getting pretty excited about the Rethinking AIDS conference. What a great opportunity to meet all of the AIDS Denialists and learn about their latest delusions! I am familiar with the venue – same place Peter Duesberg held his Aneuploidy Conference. Truth is the Aneuploidy meeting attempted to present some science. There were some real scientists there, albeit not very comfortably. The Rethinking AIDS Conference promises to be even better. Just look at what the AIDS Deniers are saying…

Duesberg's Medical Hypotheses Article Makes the Case for Peer Review

Having just posted my simulated peer review of Peter Duesberg’s shameful and retracted article where he once again proclaims that HIV is harmless, I could not resist sharing this. The UK’s premiere debunker of medical fraud and Bad Science, Ben Goldacre, writes about Duesberg’s retracted article in his weekly Guardian column. Once again, Goldacre delivers a very insightful piece. By the way, if you have not read Ben’s book Bad Science get it now… The chapter on AIDS Denialism and Matthias Rath is a real gem. If you are ever in London and have a chance to hear Ben Goldacre lecture, don’t miss him. The guy is a genius.

UPDATE: New article on retracted paper at AIDS Beacon

Peer review is flawed but the best we've got
Ben Goldacre The Guardian, Saturday 12 September

Peer Reviewing Peter Duesberg – REJECTED—RETRACTED—REJECTED Again

This summer’s saga of Peter Duesberg’s Medical Hypotheses retracted article should probably be put to rest. The sad story of this broken scientist has been told many times. Here though Duesberg reaches an all time low as he teams up with pseudoscientist Henry Bauer to yet again claim that HIV is harmless.

Duesberg and his long time accomplice David Rasnick along with Loch Ness Monster Scholar Henry Bauer published the article “HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective” in the non-peer reviewed journal Medical Hypotheses. The article focused on the South African AIDS epidemic and research reported by Harvard scientist Dr. Pride Chigwedere in the respected Journal of AIDS. Duesberg disputes the death of over 300,000 South Africans and 30,000 babies unnecessary infected with HIV. Duesberg and Rasnick have a stake in denying AIDS in South Africa because they advised former President Thabo Mbeki to deny AIDS and delay HIV treatments. Duesberg’s ideas were so flawed that the publisher, Elsevier Science, took the unusual step of retracting the article.

New York Times Reviews AIDS Denialist Crockumentary 'House of Numbers'

AIDS Seen From a Different Angle
By JEANNETTE CATSOULIS
Published: September 4, 2009

Couched as a “personal journey” through the history of H.I.V. and AIDS, “House of Numbers” is actually a weaselly support pamphlet for AIDS denialists. Trafficking in irresponsible inferences and unsupported conclusions, the filmmaker Brent Leung offers himself as suave docent through a globe-trotting pseudo-investigation that should raise the hackles of anyone with even a glancing knowledge of the basic rules of reasoning.

Magic Johnson Turns 50 and He Thanks HIV Treatments

Where were you November 7 1991?

I know precisely where I was.

My student Tricia Hunter and I had just finished collecting AIDS attitude and behavior surveys in the Chicago transit system. We had been conducting a behavioral surveillance study with a cross section of the city. That is, we were asking the good people of Chicago to fill out surveys as they waited for their train.

I came home that evening to find Magic Johnson on the news. Earvin Magic Johnson, arguably the most recognized face in professional basketball, announced his retirement after testing HIV+.

I was in Chicago. Michael Jordon’s Chicago. The Champion Chicago Bull’s Chicago.

Perhaps with the exception of LA, no city could have been more stunned by Magic’s announcement than Chicago.

Goodbye Duesberg's and Ruggiero's Articles! Did You Ever Exist?

Over the past couple of months two AIDS Denialism articles were published in a journal called Medical Hypotheses. These papers surprised many of us because Medical Hypotheses was once a peer-reviewed medical journal that is printed by the world’s largest science publisher Elsevier. But it did not take much to notice that these papers were not peer reviewed.

The article “Aids denialism at the ministry of health” by Marco Ruggiero (seen here at the gates of UC Berkeley) was received by Medical Hypotheses on June 3, 2009 and was accepted on June 3, 2009. Hmmm, now that was fast. And the article “HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective” by Peter H. Duesberg, Joshua M. Nicholson, David Rasnick, Christian Fiala, and Henry H. Bauer was received on June 9, 2009 and accepted on June 11, 2009. Obviously the Editor at least contemplated Duesberg’s article before accepting it. Just as obvious, neither paper underwent peer review.

On the Brink of Denialism: Why Peter Duesberg is Wrong and David Crowe is a Liar

Here is a real gem.

Onnie Mary Phuthe, an HIV+ woman from Botswana, wrote to South African AIDS Denialist Anthony Brink to ask about the organization Rethinking AIDS. The exchange is posted at AIDS Myth Exposed.

Brink’s response reminds me of a conversation I had with him while he was in Berlin attending an AIDS Dissident's Conference. I asked Brink about Peter Duesberg and he replied that Duesberg was washed up – old hat. The new ideas in AIDS dissidence were coming from contemporary scientists like Etienne de Harven. That seemed remarkable seeing as Peter Duesberg is 73 years old and de Harven is even older at age 81! Ah, the new ideas of AIDS Denialism.

Yet, I often wondered what Anthony Brink felt deep down about Rethinking AIDS and the people I had come to know as North America’s leading AIDS Deniers. Brink after all is responsible for feeding AIDS Denialism to the suspicious intellectual and former South African President Thabo Mbeki – ultimately bringing 300,000 of his fellow countrymen and 30,000 babies to their unnecessary deaths. Now Anthony Brink gives us some insight through his reply to Onnie. It
humoursly shows the infighting among AIDS Deniers, especially the Perth People and Duesbergians. This is worth a read. But be ready, Anthony Brink is not thrifty with words.

Shooting a Moon at AIDS Denialism

Twenty-eight years after identifying the first cases of AIDS and 13 years since highly effective combinations of antiretroviral medications made HIV infection manageable, there are AIDS Deniers who actually believe HIV is a myth.

And 40 years since Neil Armstrong took man’s first step on the moon, there are people who still believe it was a hoax. AIDS Denial is just one of many types of denialism, all of which are bound together by mistrust and paranoia. Denialists universally expose cover ups and conspiracies in their effort to rewrite history. So here you go AIDS Denialists, meet your cousins the Lunar Landing Hoaxers.

Vocal Minority Insists It Was All Smoke and Mirrors
By JOHN SCHWARTZ, New York Times, July 13, 2009

They walk among us, seemingly little different from you or me. Most of the time, you would never know of their true nature — except that occasionally, they feel compelled to speak up.

Vito Mbeki?: AIDS denialism at the Italian Ministry of Health

A policy analysis raises the specter of AIDS Denialism in the Italian Health Ministry. The study examined official records and found numerous cases where an AIDS diagnosis is discussed independent of HIV infection.

The authors initially investigated epidemiological evidence regarding HIV infection and AIDS in Italy using only official data published by the Italian National Institute of Health (Istituto Superiore di Sanità) and by the Italian Ministry of Health (Ministero del Lavoro, della Salute e delle Politiche Sociali). The authors concluded that the Italian Ministry of Health appears to be convinced that HIV is not the [sole] cause of AIDS. The authors describe the serendipity of their findings:

“In the wake of the recent Nobel awards for Medicine, we wished to prepare an essay concerning the numbers of the AIDS epidemic in Italy and the efficacy of the Italian Ministry of Health’s policies to contain and fight the disease. We also wondered whether the Nobel awards could put an end to the polemics concerning the viral origin of AIDS with particular reference to the theses (often referred to as ‘AIDS denialism’) put forward by Prof. Duesberg et al. and Bauer. AIDS denialism refers to the views of a loosely connected group of individuals and organizations who deny that HIV is the cause of AIDS. To this end, a young student (MPG) preparing his bachelor’s thesis began to search the official documents of the Italian Ministry of Health (http://www.ministerosalute.it) and, after a thorough search, we came to a rather paradoxical conclusion: policies, guidelines, definitions and data provided for by the Italian Ministry of Health are indeed consistent with the hypothesis that AIDS could be independent of HIV infection.”
The authors go on to state: “according to the Ministry, AIDS can be diagnosed in the absence of signs of HIV infection; there is legal prohibition to communicate new HIV infections to referring physicians and Health Authorities as if HIV spread were not a threat to public health… no national registry of HIV infection is implemented; and AIDS is not classified among relevant infective diseases nor among infective diseases that are susceptible of control interventions; one fourth of pediatric AIDS cases is not imputable to mother–son transmission.”

"Speaking in Tongues": An Essay on AIDS Denial by John Boucher

I stood in the doorway waiting for ten minutes before I went back to see who he was talking to. I listened in the hall at the door to his office. I could hear him saying the names of his four brothers and one sister. I could hear him asking about snow and the vegetable garden. I heard him say, “Mama, I’ve got cancer.” I waited for Rex on our couch. We had picked it out as our third anniversary present to each other.

When Rex got off the phone he found me waiting for him on our couch. The couch we picked out / the couch we made love on / the couch we watched TV on / the couch we read to each other on / the couch we fought on / the couch we had our weekly check in with each other on / the couch we almost broke-up on / the couch I would wait on with my parents, to go to his funeral. The couch I finally had to throw out.

Justice After AIDS Denialism: Should There Be Prosecutions and Compensation?

COMMENTARY
By Nathan Geffen

published in Journal of Acquired Immune Deficiency Syndromes

Edward Mabunda died on April 9, 2003. At least another 600 people died of AIDS in South Africa that day.(1) Edward was just 36 years old. He left behind a wife and 3 children. He was also a leader in the Treatment Action Campaign (TAC). He became an icon of the movement because of the fiery poetry that he recited to thousands of people. His poems urged former President Thabo Mbeki to make antiretrovirals (ARVs) available in South Africa’s public health system. He died because he could not obtain these life-saving medicines in time.(2)

From 1999 to 2007, Mbeki and his Minister of Health Manto Tshabalala-Msimang obstructed and then undermined the implementation of highly active ARV treatment (HAART) and prevention of mother-to-child transmission of HIV in the public health system. Two studies, conducted independently of each other, conservatively calculated that over 300,000 people died because of Mbeki’s AIDS denialist policies.(3–5) Edward Mabunda was one of them. These studies could not account for additional deaths due to the promotion of quackery, often with the health minister’s support. They also did not consider the number of infections that occurred because of the confusion generated by the insipid state-funded prevention campaign and the messages by some outspoken Mbeki supporters dismissing the link between sex and HIV infection.(6) The Mbeki era also fostered a profound mistrust of scientific medicine, the consequences of which also cannot be quantified.

What, if any, repercussions should be there for those responsible for this tragedy? The Rome Statute of the International Criminal Court, to which South Africa is a signatory, defines the ‘‘intentional infliction of conditions of life, inter alia the deprivation of access to food and medicine, calculated to bring about the destruction of part of a population’’ as a crime against humanity.(7) President Mbeki did not execute people with guns or bombs, but he did have the power and responsibility to prevent several hundred thousand deaths. Yet, he and his health minister chose to ignore the scientific consensus and the vociferous demands of South African civil society groups like the TAC. Questioning scientific consensus is the prerogative of a political leader, but in this case, the consensus was overwhelming. Furthermore, dissent from the consensus, that is, the arguments of AIDS denialists, had been shown to be ludicrous long before Mbeki became president,(8) and the consequences of that dissent were always likely to be disastrous. Therefore, Mbeki must surely be held responsible for the disastrous aftermath of his policy choices.

This raises the possibility that he and Tshabalala-Msimang should be prosecuted. In 2003, the TAC laid a complaint of culpable homicide with the police against Tshabalala- Msimang.(9) The organization provided a detailed ‘‘docket’’ describing the evidence against her. The complaint was largely symbolic and part of a civil disobedience campaign that would ultimately change government policy. But perhaps, it is time to go beyond symbolism.

I am unaware of any other case in the history of the modern democratic state in which so many have died because political leaders willfully contradicted scientific advice. However, there have been instances in which political leaders have been successfully prosecuted for negligent behavior with far greater extenuating circumstances. For example, Edmond Herve, the former French health minister, was convicted for his role in the contamination of his country’s blood supply with HIV in the 1980s. Mbeki’s folly is in danger of being repeated: political leaders who use pseudoscientific arguments to deny the reality of global warming are also at risk being culpable of many deaths. Setting a precedent that will make politicians think twice before making this kind of error is an important reason to prosecute Mbeki and his advisors.

What about those who aided or failed to stop his and Tshabalala-Msimang’s policies? Alec Erwin, the Minister of Trade and Industry at the time, failed to take any of the steps available to him to bring down ARV prices and was consequently named as Tshabalala-Msimang’s coaccused in the TAC docket. The Parliamentary Portfolio Committee on Health is responsible for oversight of the Health Department. Yet, its head, James Ngculu, failed to hold Tshabalala- Msimang to account for her actions. Only a handful of the hundreds of African National Congress Members of Parliament spoke out publicly against Mbeki’s policies. Only 1 provincial government, the Western Cape, implemented prevention of mother-to-child transmission and HAART programmes expeditiously. The premiers and health ministers of the other 8 provinces, for the most part, failed to do so.

Also, what about scientists like Peter Duesberg and David Rasnick who provided a veneer of scientific credibility for Mbeki’s views? Can Duesberg, the most prominent scientist to promote AIDS denialism, claim that the principles of academic freedom and freedom of expression protect him from sanction? Or is his situation not analogous to a financial advisor who provides fraudulent information, except in Duesberg’s case, the misinformation is deadly? Rasnick is even more implicated. He was found by a South African court to have conducted an unlawful clinical trial when he teamed up with vitamin salesman Matthias Rath and others to provide multivitamin tablets as an alternative to HAART to people dying of AIDS.(10) He loudly supported and encouraged the South African government’s refusal to provide HAART. He usually signed his articles as a member of Mbeki’s notorious AIDS advisory panel that was convened in 2000 to create the impression that there was a genuine scientific controversy about the cause of AIDS.(11,12)

What about Matthias Rath himself or the hundreds of other charlatans who provided quack treatments for AIDS with impunity during Tshabalala-Msimang’s reign, despite legislation preventing the sale of unregistered medicines for viral infections? Hardly, any have been prosecuted. Rath, for example, has had a plethora of civil court rulings and regulatory body warnings and findings against him in Germany, the United Kingdom, United States, and South Africa.(13) But, despite breaching South Africa’s Medicines Act, for example, no criminal proceedings against him have been initiated.

There is also the question of compensation. Although it is too late for those who have died, surely their families are entitled to redress? Determining compensation would be extremely difficult of course. Over 2 million South Africans died of AIDS during Mbeki’s reign. It is impossible to determine precisely that 300,000 lives could have been saved. For 1 thing, many people died without ever being tested and their HIV statuses will never be known.
Nevertheless, at least some families would be able to make unequivocal claims that 1 or more of their members died directly as a consequence of the state’s failure to provide medicines.

Answering the above questions will be difficult and controversial. They raise profound legal and moral predicaments. Ideally, the South African government should establish an independent Commission of Inquiry whose purpose would be to provide recommendations on what, if any, action should be taken against those responsible for the country’s AIDS denialist policies. Former deputy-health minister Nozizwe Madlala-Routledge, who was fired by Mbeki arguably for her anti-denialist position, has already suggested this.(14) The commission should also consider the issue of compensation. South Africa’s new president, Jacob Zuma, has the power to institute it. This would be an excellent way for him to demonstrate that he is serious about accountability for the response to the HIV epidemic. Surely such a process is the minimum that the victims of AIDS denialism, their families and friends are entitled to? Edward Mabunda would have thought so.

REFERENCES
1. Actuarial Society of South Africa. ASSA 2003 [Internet]. Available at: http://actuarialsociety.co.za/Models-274.aspx. Accesed January 8, 2008.
2. TAC. TAC newsletter on the death of Edward Mabunda [Internet]. April 9, 2003. [cited January 5, 2009]. Available at: http://www.tac.org.za/newsletter/2003/ns09_04_2003.htm.
3. Chigwedere P, Seage G, Gruskin S, et al. Estimating the lost benefits of antiretroviral drug use in South Africa [Internet]. J Acquir Immune Defic Syndr. 2008. [cited January 5, 2009]. Available at: http://www.ncbi.nlm. nih.gov/pubmed/18931626.

4. Nattrass N. AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa [Internet]. African Affairs. 2008;107:157–176. [cited September 11, 2008]. Available at: http://afraf.oxfordjournals.org/cgi/content/abstract/107/427/157.
5. Bourne DE, Thompson M, Brody LL, et al. Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa [Internet]. AIDS. 2009;23:101–106. [cited January 7, 2009]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19065753.
6. TAC. The Citizen’s publicity for AIDS denialists is irresponsible [Internet]. 2006. [cited January 12, 2009]. Available at: http://www.tac.org.za/community/node/2214.
7. International Criminal Court. Rome Statute of the International Criminal Court [Internet]. 2002 July 1. [cited January 5, 2009]. Available at: http:// www.icc-cpi.int/about.html.
8. NIAID. The Relationship between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome [Internet]. 1995 September. [cited February 6, 2009]. Available at: http://www.aidstruth.org/documents/NIH1995DocumentExplainingThatHIVCausesAIDS.pdf.
9. TAC. TAC Civil Disobedience Campaign [Internet]. March 20, 2003. [cited January 5, 2009]. Available at: http://www.tac.org.za/newsletter/ 2003/ns20_03_2003.htm#Docket.
10. Zondi J. Judgment in TAC and SAMAv. Rath and Others [Internet]. 2008. Available at: http://www.tac.org.za/community/files/file/TACAndSAMAVersusRathAndGovernmentJudgment.pdf.
11. Rapid Responses for Shelton et al. BMJ. 328:891–893 [Internet]. [cited January 14, 2009]. Available at: http://www.bmj.com/cgi/eletters/328/ 7444/891.
12. Government of South Africa. Presidential AIDS Advisory Panel Report [Internet]. March 2001. [cited January 13, 2008]. Available at: http://www.info.gov.za/otherdocs/2001/aidspanelpdf.pdf.
13. TAC. The Wrongs of Matthias Rath [Internet]. [cited January 7, 2009]. Available at: http://www.tac.org.za/community/rath.
14. Karrim Q. Calls for Aids TRC. Mail & Guardian. Available at: http://www.mg.co.za/article/2009-04-03-calls-for-aids-trc. Accessed April 27,2009.

Correspondence to: Nathan Geffen, MSc, Treatment Action Campaign, 2nd Floor, Westminster House, Cape Town 8001, South Africa (e-mail: nathangeffen@gmail.com).
Copyright _ 2009 by Lippincott Williams & Wilkins

AIDS denial: A lethal delusion

ON 27 December 2008, a well-heeled 52-year-old woman died in a Los Angeles hospital. Her death certificate describes a body riddled with opportunistic infections typical of the late stages of AIDS. Christine Maggiore had tested HIV positive 16 years earlier, but she had shunned ART, the antiretroviral therapy that stops HIV replicating and prevents AIDS.

This was not the first time a death in Maggiore's family had made headlines: five years earlier her 3-year-old daughter Eliza Jane had died. The autopsy described a chronically ill little girl who was underweight, under-height, and had encephalitis and pneumonia - all AIDS-related. When pregnant, Maggiore had again rejected ART and she had breastfed Eliza Jane, another way of transmitting the virus.

Why, in 21st-century California, would a middle-class woman and her young daughter die like this when there is tried-and-tested treatment for their illness? The answer lies in a bizarre medical conspiracy theory that says AIDS is not caused by HIV infection (see Five myths about HIV and AIDS).
[UPDATE: further discussion of the New Scientist artcle is posted at GayNZ.com]
It is tempting to dismiss the so-called AIDS denialism movement out of hand, but it has a strong internet presence, with a plethora of websites and blogs that can mislead the unwary. While the movement has lately suffered some significant blows to its credibility, it has in the recent past wielded extraordinary influence, especially in southern Africa, the centre of the world's AIDS epidemic. "Denialism has been relegated to the fringes of the internet, but it isn't of no consequence," says John Moore, an immunologist at Weill Cornell Medical College, Ithaca, New York, and one of the world's foremost AIDS researchers. "It can still cost the lives of unsuspecting people."

The origins of the AIDS denialism movement can be traced back to 1987, four years after the discovery of HIV. Peter Duesberg was then a renowned researcher at the University of California, Berkeley, who had shown that some cancers were triggered by retroviruses. In March that year, Duesberg performed an about-face, publishing an article in which he questioned his original finding that retroviruses caused cancer, and also whether HIV (another retrovirus, although not one that he had studied) caused AIDS.

At the time, HIV science was in its infancy, and Duesberg was not the only mainstream scientist to speculate whether AIDS was actually caused by lifestyle factors such as taking drugs, for example. Indeed, New Scientist published Duesberg's manifesto of dissent in 1988.

"Duesberg did get laypeople's attention, and they, in turn, got him scientific attention," says University of California sociologist, Steven Epstein, author of Impure Science, a book on AIDS research. "Credibility was cycled back and forth."

As the clinical and epidemiological evidence linking HIV with AIDS accrued, however, support for denialism among mainstream scientists fell away. In the mid-1990s came the clincher. Cocktails of ART were found to halt the replication of HIV and reverse and prevent the development of AIDS. By the end of 1996, doctors in the west were witnessing the "Lazarus effect": AIDS patients who had been mortally ill were rising from their beds, putting on jackets and ties, and reporting for work.

By rights the denialism movement should have died out there and then. Yet it persisted. Not one of the denialists was a researcher studying AIDS or HIV - they simply critiqued the work of those who did. Much of the movement's output has been journalistic rather than scientific, spawning numerous articles, books, films (often self-published or self-produced), and lately websites. Tellingly, most of the studies they cite are quite old, reflecting the fact that mainstream support has long since died out.

Ask what the denialists do believe, however, and there is no consensus (see Five myths about HIV and AIDS). Some hark back to the early idea that AIDS in gay men is caused by amyl nitrite use; others say the cause is ART itself - although no one can explain why AIDS arose before ART was developed.

Some denialists accept that HIV may be present in those with AIDS, but claim it is just another opportunistic infection, rather than the cause. Others say, incredibly, that HIV has never been proven to exist at all.

Perhaps the most staggering of their beliefs, though, is that everyone else has got it so wrong. Denialists claim the scientific community cannot afford to admit their error because too many reputations and too many research grants are now at stake. Once ART was developed, the multibillion-dollar drugs industry had a vast investment at stake too.

It is certainly true that the scientific peer-review process can slow down the acceptance of new theories. And pharmaceutical companies hardly have a spotless record either. Yet the clinical and epidemiological evidence for the viral cause of AIDS is overwhelming, from virologists who see HIV under their microscopes, to doctors the world over who witness AIDS patients begin ART and make dramatic recoveries.

Denialism in the west continued to limp along, attracting a following of conspiracy theorists, attention seekers, peddlers of pseudoscience and HIV patients in denial. The movement's leaders vary in their credibility. Duesberg's most vocal supporter is David Rasnick, a former biochemist who makes much of his research background, as he once studied a group of enzymes called proteases. HIV possesses a protease enzyme, and protease inhibitors represent a key class of ART drugs. However Rasnick only worked on rat proteases, never on HIV's.

Then there is Henry Bauer, a retired chemistry and life sciences professor at Virginia State University in Petersburg, who edits the Journal of Scientific Exploration. This publishes research on such topics as alien abductions and telepathy. Before dabbling in virology, Bauer was a leading authority on the existence of the Loch Ness monster.

Leading AIDS denialist Henry Bauer is a former expert on the Loch Ness monster

Racism

The effects of AIDS denialism in Africa are no joke, however. In 2000, as the movement was rapidly losing all credibility, South African president Thabo Mbeki asked some of the leading denialists to sit on an advisory council to guide his response to the epidemic. On their advice he did everything in his power to resist ART use in his country.

Mbeki felt the mainstream western view that AIDS was caused by a sexually transmitted infection reflected racist beliefs that Africans were promiscuous. Western science, Mbeki believed, was blind to an obvious cause of immune deficiency in Africa: poverty.

It wouldn't be the first time. A century ago TB became endemic among black, but not white, South Africans, leaving western scientists flummoxed. Some pondered a genetic explanation, while overlooking the obvious - in white-ruled cities black people lived in the crowded conditions that encourage the spread of TB. In other words, blacks were falling ill as a result of white domination. Mbeki argued that the same thing was happening again. AIDS was simply a name for the diseases of poverty that had been legion in Africa since the days of colonial rule.

Mbeki was forced out last year - although not because of his denialism - and South Africa's new president, Jacob Zuma, supports ART. But immense damage has already been done. Last year, a study found that if Mbeki's government had provided HIV treatment, there would have been 365,000 fewer premature deaths in South Africa (Journal of Acquired Immune Deficiency Syndromes, vol 49, p 410). The legacy of Mbeki's denialism might still have an influence on the treatment decisions of many HIV-positive South Africans.

In Australia there is now the "Perth Group", led by Eleni Papadopulos-Eleopulos, whose science qualification is an undergraduate degree in nuclear physics. She appeared as an expert witness in 2006 for an Australian man appealing his conviction for failing to tell his sexual partners he was HIV-positive. Papadopulos-Eleopulos stood up in court and claimed that HIV does not exist. The man lost his case, however, with the judge noting that Papadopulos-Eleopulos had "no formal qualifications in medicine, virology, immunology, or any other medical disciplines... Her opinions lack any credibility."

Along with Christine Maggiore's death, you might think that these events would significantly weaken the denialists' case. Yet it would be premature to predict the movement's demise.

Consider that in the US, two small surveys have shown startlingly high numbers of people - around 1 in 4 - who question whether HIV causes AIDS. This probably reflects lack of education about the virus, rather than active denialism, since there is no evidence that people are seeking alternative AIDS treatment in large numbers. It does suggest, however, a troubling lack of communication between mainstream medicine and ordinary people. It is precisely such gaps in communication that internet quacks and conspiracy theorists can exploit.

Gaps in communication between mainstream medicine and ordinary people can be exploited by internet quacks and conspiracy theorists

Seth Kalichman, a psychologist at the University of Connecticut in Storrs, who carried out one of the surveys, has recently published Denying AIDS, a book about the movement. "My perception is that there is certainly a lot more mischief, like books and documentaries shown at film festivals," he says.

For some, no amount of evidence will overturn their entrenched beliefs. Maggiore blamed her daughter's death on an allergic reaction to antibiotics. For a long time she publicly cited her own good health as proof that HIV does not cause AIDS.

It is unpleasant to imagine what went through her mind last year as her own health worsened. She apparently continued to refuse the potentially lifesaving ART. Perhaps that is no surprise. To accept the drugs she had denied Eliza Jane would have been tantamount to accepting responsibility for her daughter's death.

To accept the drugs she had denied Eliza Jane would have meant taking responsibility for her child's death. And that's something that anyone would want to stay in denial about.

Note New Scientist article by Jonny Steinberg is the author of Three Letter Plague: A young man's journey through a great epidemic (Vintage), published in the US as Sizwe's Test

My year as an AIDS denialist

"For a year I had two lives," says Seth Kalichman, a psychologist at the University of Connecticut in Storrs and editor of the journal AIDS and Behavior. "It was pretty disturbing."

Kalichman was researching his book, Denying AIDS, which was published in the US earlier this year. The book charts the development of AIDS denialism into its current incarnation as a ragbag of eccentric scientists, crusading conspiracy theorists and HIV patients in denial.

Kalichman wanted to get close to the denialists - and that meant becoming one of them. "I knew that they would never talk to me as Seth Kalichman, the AIDS scientist," he says. So Kalichman became public health student "Joe" (a nickname he sometimes uses).

The denialist movement has a strong internet presence. As Joe, Kalichman started posting on websites and blogs. "I would pose questions, and they indoctrinated me into denialism," he recalls. "There were times when I felt I was being groomed."

His next step was to get Joe on an internet list of "AIDS dissidents". Denialists often cite this document, which currently has 2651 international signatories, as a list of scientists who dispute that HIV causes AIDS. In fact, only some of those listed are scientists, and even fewer are biologists - although alternative therapists often crop up.

As a budding denialist who was part of the medical establishment, Joe would no doubt have been seen as a great catch. Once he passed a brief email cross-examination, his name went up.

"That list is a roster of who can be trusted," Kalichman discovered. Joe now gained access to, and regularly chatted with, other prominent denialists, including the Canadian journalist David Crowe.

Kalichman began to find his double life surreal. "I was going to meetings at the National Institutes of Health during the day and in the evenings blogging with David Crowe," he recalls. But Kalichman wanted to meet denialists face to face. He heard that the movement's founder and star scientist Peter Duesberg was holding an invitation-only cancer conference.

SUSPICIOUS

Duesberg was once widely renowned for his discovery of the first cancer gene, but he is now derided for his eccentric views on HIV. He works in a small, privately funded laboratory where he researches his outlandish theories of cancer.

Joe's status as an AIDS dissident won him an invite. He felt nervous his subterfuge would be discovered, either by inadvertently using his real name or through his appearance. "I had been telling them I was a student, and I'm 48 years old," he says.

Still, Kalichman got through the door and talked to other attendees, including Duesberg's right-hand man David Rasnick. Rasnick seemed suspicious but did not get him thrown out.

Finally, Kalichman met Duesberg himself, and it made him revise some of his opinions about the man. Kalichman had previously wondered if Duesberg's stated views could be genuine. "He looked me dead in the eyes and said this is not an infectious disease," he says. "I have no question that he really believes this. He ignores the science to retain this belief."

Why? In Kalichman's opinion: "In that very small circle of AIDS denialism, he's a rock star. He was the focus of attention the whole time and he was very comfortable with that."

After the conference Kalichman abandoned his double life. He has no doubt that his time spent as Joe gave him unique insight into the denialists' world. "For Peter Duesberg, he's the big fish in the small pond. For people with HIV, denialism protects them from having to face that fact. Our beliefs are a substantial part of our psychological survival."

Note: Interview in New Scientist by Clare Wilson